17例乳腺实性乳头状癌的临床病理分析  

Clinicopathological analysis of 17 cases of solid papillary carcinoma of breast

作　　者：郭庆[1] 洪善超[2] 陈文凯[1] 夏钰弘[1] 

机构地区：[1]南京医科大学附属无锡市人民医院病理科,江苏无锡214023 [2]南京医科大学附属无锡市人民医院检验科,江苏无锡214023

出　　处：《临床与病理杂志》2017年第11期2378-2382,共5页Journal of Clinical and Pathological Research

摘　　要：目的:探讨乳腺实性乳头状癌(solid papillary carcinoma,SPC)的临床病理特点、免疫表型特征及鉴别诊断。方法:回顾性分析17例SPC的临床病理资料和免疫组织化学特征,结合文献对其临床病理特点进行分析。结果:17例SPC均为中老年女性,年龄39~91(中位72)岁,临床表现为乳腺肿块及乳头溢液。组织学显示肿瘤细胞呈实性巢团状结构,细胞较温和,形态较一致,呈流水样排列,可见纤维血管轴心及细胞内和细胞外黏液,可伴有不同类型的浸润性癌巢。免疫组织化学显示肿瘤细胞弥漫表达ER,PR,Cg A,Syn和CD56,肿瘤巢团及乳头轴心周围散在阳性表达肌上皮标志物CK5/6,Calponin,P63或不表达,13例患者Her-2阴性(0或1+)表达,4例患者显示Her-2不确定阳性(2+),所有患者DSISH检测均无扩增。结论:SPC是一种相对少见的乳腺肿瘤,具有独特临床病理特征,多发生于中老年女性患者,组织病理学及免疫组织化学对SPC的明确诊断和鉴别诊断具有肯定价值,预后较好。Objective： To investigate the clinicopathological features, immunophenotypes, and differential diagnosis of solid papillary carcinoma（SPC） of breast. Methods： Histopathological characteristics and immunohistochemical markers were studied retrospectively and the relevant literatures were reviewed. Results： Seventeen elderly women patients, aged from 39 to 91（median =72） years, were all with breast mass or nipple discharge. Histologically, the tumor cells showed a solid nest structure. The cells were more moderate and uniform, which were arrayed like water samples, vascular axis and intracellular or extracellular mucus is visible, maybe associated with different types of invasive cancer nests. Immunohistochemically, tumor cells expression of ER, PR, Cg A, Syn and CD56 were positive. CK5/6, Calponin and P63 of solid nest peripheral myoepithelial were scattered positive or no expression. Thirteen patients were with negative Her-2 expression, 4 patients Her-2 positive expression was uncertainty, DSISH amplification was not detected with all patients. Conclusion： SPC is a rare breast tumor with unique clinical and pathological features, mostly in the elderly women. Histopathology and immunohistochemical marker are definite valuable for diagnosis and differential diagnosis with better prognosis.

关 键 词：乳腺 实性乳头状癌 临床病理学 免疫组织化学 鉴别诊断 

分 类 号：R737.9[医药卫生—肿瘤]